Abstract
Background Patients with AF often have multimorbidity (the presence of ≥2 concomitant chronic conditions). Objective To describe baseline characteristics, patterns of antithrombotic therapy, and factors associated with oral anticoagulant (OAC) prescription in patients with AF and ≥2 concomitant, chronic, comorbid conditions. Methods Phase III of the GLORIA-AF Registry enrolled consecutive patients from January 2014 through December 2016 with recently diagnosed AF and CHA2DS2-VASc score ≥1 to assess the safety and effectiveness of antithrombotic treatment. Results Of 21,241 eligible patients, 15,119 (71.2%) had ≥2 concomitant, chronic, comorbid conditions. The proportions of patients with multimorbidity receiving non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKA) were 60.2% and 23.6%, respectively. The proportion with paroxysmal AF was 57.0% in the NOAC group and 45.4% in the VKA group. Multivariable log-binomial regression analysis found the following factors were associated with no OAC prescription: Pattern of AF (paroxysmal, persistent, or permanent), coronary artery disease, myocardial infarction, prior bleeding, smoking status, and region (Asia, North America, or Europe). Factors associated with OAC prescriptions were age, body mass index, renal function, hypertension, history of cerebral ischemic symptoms, and AF ablation. Conclusion Multimorbid AF patients prescribed NOACs have fewer comorbidities than those prescribed VKAs. Age, AF pattern, comorbidities, and renal function are associated with OAC prescription.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | e0249524 |
| Tidsskrift | PLOS ONE |
| Vol/bind | 16 |
| Udgave nummer | 4 |
| Antal sider | 34 |
| ISSN | 1932-6203 |
| DOI | |
| Status | Udgivet - 14 apr. 2021 |
Bibliografisk note
Funding Information:Competinginterests:Theauthorshavereadthe journal’spolicyandhavethefollowingcompeting interests:Dr.Teutsch,SabrinaMarler,and VenkateshK.Gurusamyarepaidemployeesof BoehringerIngelheim.Dr.Luwasapaidemployee ofBoehringerIngelheimatthetimethatthe manuscriptwaswritten.ProfessorHalperinhas engagedinconsultingactivitiesforBoehringer Ingelheimandadvisoryactivitiesinvolving anticoagulants,andheisamemberofthe ExecutiveSteeringCommitteeoftheGLORIA-AF Registry.Overthepast3years,ProfessorDiener receivedhonorariaforparticipationinclinicaltrials, contributiontoadvisoryboards,ororal presentationsfrom:Abbott,BayerVital,Bristol-MyersSquibb,BoehringerIngelheim,Daiichi Sankyo,Medtronic,Pfizer,Portola,Sanofi-Aventis, andWebMDGlobal.Financialsupportforresearch projectswasprovidedbyBoehringerIngelheim.He receivedresearchgrantsfromtheGerman ResearchCouncil(DFG),GermanMinistryof EducationandResearch(BMBF),EuropeanUnion, NIH,BertelsmannFoundation,andHeinz-Nixdorf Foundation.ProfessorMareceivedhonorariafrom Bristol-MyersSquibb,Pfizer,Johnson&Johnson, BoehringerIngelheim,Bayer,andAstraZenecafor givinglectures.ProfessorHuismanreportsgrants fromZonMWDutchHealthcareFund,grantsand personalfeesfromBoehringerIngelheim,Pfizer/ Bristol-MyersSquibb,BayerHealthCare,Aspen, DaiichiSankyo,outsidethesubmittedwork. ProfessorLiphasbeenaconsultantforBayer/ Janssen,Bristol-MyersSquibb/Pfizer,Medtronic, BoehringerIngelheim,Novartis,Verseon,and DaiichiSankyo.HehasbeenaspeakerforBayer, Bristol-MyersSquibb/Pfizer,Medtronic,Boehringer Ingelheim,andDaiichiSankyo.Nofeesdirectly receivedpersonally.Thesecompetinginterestsdo notalterouradherencetoPLOSONEpolicieson sharingdataandmaterials.Therearenopatents, productsindevelopmentormarketedproducts associatedwiththisresearchtodeclare.DrKozieł andProfessorRothmandeclarenocompeting interests.
Publisher Copyright:
© 2021 Koziel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.